Have I got tuberous breasts? (photos)

Question

I want a breast augmentation because I'm not happy with the shape and size of my breasts. I have gone to see 3 surgeons and one has told me my breast are mildly tuberous. I can understand what he means as they do have some characteristics of tuberous breasts but I was concerned that the other two doctors didn't mention that to me. It would be good to have another opinion on this. The doctor who said I had tuberous breasts also recommenced teardrop implants whilst the others said round.

Ted Eisenberg, DO, FACOS, FAACS · Answer

Unfortunately, surgeons have created the term tuberous breasts, a fact which causes unnecessary concerns for women. Many women just have different sizes and shapes and in my opinion shouldn't be labeled. I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size implants, if interested. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Benjamin Baker, BMBS MBA FRCS(Plast) · Answer

Thanks for your question. You do have some features of tuberous breast change, for example a constricted left lower pole, in addition to breast asymmetry. The overall shape could be improved with breast implants, specifically with the aim of augmenting and stretching out the lower pole of the breast. The conversation around anatomical vs round implants in your case is quite nuanced and would be best addressed in a face to face consultation with a plastic surgeon with a specialist interest in aesthetic breast surgery.

Amir Sadr, MD, MSc (Plast), FEBOPRAS · Answer

Dear Luminous971326
Thanks for sharing your photos, I agree with the surgeon that said you may have mildly tuberous breasts. 
It is difficult to give a final diagnosis without a clinical examination but presence of certain features such as, wide herniated areolas, inadequate breast tissue at the lower pole of breasts and a slightly pointed shape of the breasts is in favour of a diagnosis of tuberous breasts.
I believe this can be corrected through breast augmentation surgery using round silicone implants. Using anatomic shaped implants will put you at a risk of the implant rotating which can not be corrected without further surgery. This risk is non-existent with round implants.

Riaz Agha, MBBS, DPhil(Oxon), FRCS(Plast) · Answer

There are certainly some hallmarks of tuberous breasts. So a large areola with early herniation, high tight IMF and lack of a inferomedial quadrant of the breast. I would recommend Ergonomix implants (see video). It may need to be combined with other procedures like facial release, fat grafting, areolar reduction, addressing the herniation, etc.

Georgios Orfaniotis MD, FRCS(Plast) · Answer

You do not have the classic tuberous breast deformity. However, you lower pole is slightly constricted, especially on the Left side. The nipple to fold distance is short, and your areolas are relatively large. There is also some asymmetry in both volume and shape, with the Left fold sitting higher. You obviously need a proper assessment before any surgery but based on your pics I would recommend smooth ergonomix implants placed in a dual plane pocket (partially under the muscle). Your Left breast needs a larger implant - approximately 50 Cc larger than the right.Your Left fold needs to be lowered. You also need to consider a peri-areolar or donut lift, with a scar around the nipple. This will reduce the size of your areolas and slightly lift the nipple to a more balanced position. Not the easiest surgery but if performed well you can achieve a beautiful and natural result. Best wishes

Stefan Mark Szczerba, MD · Answer

Just out of principle with textured, shaped implants, I don't do them.  There is a small risk of a very rare lymphoma with textured implants- so I recommend smooth.  The degree of tuberous change you have is small, so I'd do a regular breast augmentation and see how it turns out before I do something more invasive to correct the tuberous appearance.  Best Wishes!!

Donald R. Revis Jr, MD · Answer

Good afternoon,
Your breasts are not tuberous, you just have a moderately large gap, and your areolas are a little large in proportion to your breast size. I would recommend submuscular placement of saline or silicone gel implants, depending on your preference. We would figure out the exact size and profile when I measure your chest, we review photos together, and you have an opportunity to try on the implant sizers here in the office! Teardrop implants are a terrible idea- they have a higher complication rate and are even related to a weirdo breast lymphoma called BIA-ALCL. Choose smooth round implants! Anyone still using anatomical textured implants is behind the times!

Gary M. Horndeski, MD · Answer

Your breasts are small and widely separated but do not appear tuberous. Augmentation alone will not solve your problem. The technique I recommend is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Luminous971326,
tuberous breasts are not simply small or underdeveloped breasts. The appearance of the breast can range from mild to severe, and typical traits include: enlarged, puffy areola, rather wide spacing between the breasts, very little breast tissue, sagging, higher than normal inferior breast fold, and narrow base at the chest wall.The type of surgery best for you will depend on the severity of your condition.My preferred technique for tuberous breast correction involves a multistep procedure where the breast tissue is released in a radial pattern to prevent herniation into the areola and placement of a custom implant size is in the breast to allow appropriate expansion of the breast in the restricted dimensions. This can often be done in a single procedure but sometimes may require two surgeries.That said, it is best that you visit a board-certified plastic surgeon for an in person examination. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Charles Durrant, MA, MBBS, FRCS(plast) · Answer

Yout breasts are mildly tuberous. There is some nipple/areola herniation and a deficit of tissue in the lower medial breast on the right and the lower pole on the left. A teardrop implant might be better at filling out this lower pole but it's not hugely important in your case. Go with whichever surgeon you feel most comfortable with. Good luck

Have I got tuberous breasts? (photos)

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